APHON Pediatric Chemotherapy-Biotherapy Renewal

– ensure explicit and transparent communication with patients and families about drug shortages ! using evidence-based strategies to minimize the impact of drug shortages by maximizing efficiency and eliminating waste through interventions such as – grouping patients receiving the same therapy into cohorts to share vials during drug preparation – reducing advance preparation of drugs that may lead to waste – using safe dose-rounding practices to eliminate waste – evaluating drugs’ expiration times and shelf life to extend the period of safe drug use ! developing institutional interdisciplinary drug allocation committees that – include physicians, pharmacists, nurses, social workers, members of institutional ethics committees, and patient representatives – apply ethical decision-making principles – explore reasonable therapeutic drug alternatives – make prioritization decisions that are applied equitably to patients affected by drug shortages – provide an appeal process for patients and families who have been affected by drug allocation decisions ! showing respect for patients and caregivers by informing them about drug shortages and the process by which allocation decisions are made.

APHON’s position paper (Bunnell et al., 2020, p. 3) continues by offering these recommendations: that nurses

! become informed both about the causes and impact of drug shortages and about current recommendations to prevent or reduce the impact of drug shortages on public health ! advocate for and participate in institutional drug shortage and allocation committees ! ensure that families receive current and reliable information about drug shortages and the subsequent management plan for their child’s care ! refrain from implementing individual strategies (e.g., drug hoarding) that, although well- intentioned, may compromise the delivery of safe, ethical, and high-quality care